Downeast Treatment Center Sees Success with Hub and Spokes Model of Care
Date: 12/05/2018
As the Senior Physician Executive for Northern Light Blue Hill Hospital, Mike Murnik, MD has seen the devastating effects of Maine’s opioid crisis first-hand. With opiate-related overdose deaths rising in the state over the last five years, Dr. Murnik knew there was a need for more treatment services in Hancock County and western Washington County, and a need to increase access to those services.
“People were dying,” Dr. Murnik said. “But it was really hard for them to get into treatment.”
It was a concern shared throughout the community. A series of monthly meetings began four years ago to discuss the crisis. Held at Ellsworth Town Hall, these meetings bring together law enforcement, healthcare providers, substance abuse counselors and other community partners who are attempting to mitigate the crisis. Through these ongoing discussions, they developed an idea: a treatment hub where people dealing with opiate use disorder could get stabilized and then move out into the community for maintenance and counseling.
In April, this idea became a reality: Northern Light Blue Hill Hospital, Northern Light Maine Coast Hospital in Ellsworth, and MDI Hospital in Bar Harbor partnered with the Aroostook Mental Health Center and Healthy Acadia to open the doors of the Downeast Treatment Center to the community.
The Downeast Treatment Center provides outpatient treatment for patients with Opiate Use Disorder through a “hub and spokes” care model. At the Center – the hub – those affected receive counseling and medication assisted treatment (MAT). Once they are stabilized and improving, these patients are connected with primary care provider “spokes” in the community who can continue ongoing care, including MAT. As a result, treatment can be initialized more immediately, and the patient has more support as they taper off their medication, and after.
Dr. Murnik said this model is particularly helpful given the nature of the disease.
“The Center is set up to help with relapses which can be typical because this is a chronic, relapsing disease,” he said. “If a person falls off the wagon and starts using again, they can go back to the hub for stabilization, and then go back out to the spokes.”
After only seven months, several patients have been successful after entering the hub and progressing to the spokes.
“One graduate is now stabilized and applying for a job,” Dr. Murnik said. “And another is completely off of Suboxone. They’ve tapered off completely and are doing well so far.”
Dr. Murnik, however, acknowledges there’s still more work to be done. His team is leading other initiatives to fight this epidemic, including implementing a model for initiating treatment in the emergency room that was pioneered by Yale-New Haven Hospital in Connecticut.
Dr. Murnik said ongoing community collaboration will continue to be vital in combatting Maine’s opioid crisis.
“Addressing this as a community is key,” he said. “This problem is as prevalent as diabetes, but there’s still such a stigma. We need to figure this out and continue to meet people where they are. We have to make it easier to provide treatment and medications.”
Dr. Murnik is up for the challenge and making positive changes.
“Our providers tell me that some of the most rewarding work they do is MAT, seeing people turn their lives around and get back to their families and back to work. The DETC and the Hub and Spokes Program make it easier for providers to do that work and for community members in need to get into treatment.”
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